medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2023-281medsovet-7782Research ArticleПРЕ- И ПОСТМЕНОПАУЗАPRE- AND POSTMENOPAUSEОценка эффективности и безопасности применения различных нестероидных противовоспалительных препаратов у женщин в постменопаузе с воспалительным фенотипом остеоартритаEvaluation of the efficacy and safety of various non-steroidal anti-inflammatory drugs in postmenopausal women with an inflammatory phenotype of osteoarthritishttps://orcid.org/0000-0002-0475-8391ШафиеваИ. А.ShafievaI. A.

Шафиева Ирина Алексеевна - кандидат медицинских наук, врач-ревматолог высшей квалификационной категории, заведующая отделением эндокринологии и ревматологии.

443079, Самара, проспект Карла Маркса, д. 165б

Irina A. Shafieva - Cand. Sci. (Med.), Rheumatologist of the Highest Qualification Grade, Head of Department of Endocrinology and Rheumatology, Clinics of Samara State Medical University.

165b, Karl Marx Ave., Samara, 443079

ifabtdf@yandex.ruhttps://orcid.org/0000-0003-0027-1786БулгаковаС. В.BulgakovaS. V.

Булгакова Светлана Викторовна - доктор медицинских наук, доцент, заведующая кафедрой эндокринологии и гериатрии, СамГМУ; главный внештатный специалист по гериатрии, МЗ Самарской области.

443099, Самара, ул. Чапаевская, д. 89; 443010, Самара, ул. Ленинская, д. 73

Svetlana V. Bulgakova - Dr. Sci. (Med.), Associate Professor, Associate Professor, Head of Department of Endocrinology and Geriatrics Samara State Medical University; Chief External Expert in Geriatrics, Ministry of Health of Samara Region.

89, Chapaevskaya St., Samara, 443099; 73 Leninskaya St., Samara, 443099

osteoporosis@gmail.comhttps://orcid.org/0000-0002-0865-0687ШафиеваА. В.ShafievaA. V.

Шафиева Алена Витальевна - ординатор 2-го года кафедры факультетской терапии.

443099, Самара, ул. Чапаевская, д. 89

Alena V. Shafieva - second-year resident physician, Intermediate Level Therapy Department, Samara State Medical University.

89, Chapaevskaya St., Samara, 443099

alyona.go123@gmail.comhttps://orcid.org/0000-0003-4114-5233КурмаевД. П.KurmayevD. P.

Курмаев Дмитрий Петрович - кандидат медицинских наук, ассистент кафедры эндокринологии и гериатрии.

443099, Самара, ул. Чапаевская, д. 89

Dmitriy P. Kurmayev - Cand. Sci. (Med.), Teaching Assistant of Department of Endocrinology and Geriatrics, Samara State Medical University.

89, Chapaevskaya St., Samara, 443099

geriatry@mail.ruКлиники Самарского государственного медицинского университетаРоссияClinics of Samara State Medical UniversityRussian FederationСамарский государственный медицинский университет; Министерство здравоохранения Самарской областиРоссияSamara State Medical University; Ministry of Health of Samara RegionRussian FederationСамарский государственный медицинский университетРоссияSamara State Medical UniversityRussian Federation202320102023015104110Copyright © Шафиева И.А., Булгакова С.В., Шафиева А.В., Курмаев Д.П., 20232023Шафиева И.А., Булгакова С.В., Шафиева А.В., Курмаев Д.П.Shafieva I.A., Bulgakova S.V., Shafieva A.V., Kurmayev D.P.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/7782Введение

Введение. Основой лечения болевого синдрома при остеоартрите (ОА) в настоящее время являются нестероидные противовоспалительные препараты (НПВП). Для НПВП характерна индивидуальная реакция на препарат, а также достаточно высокая частота побочных проявлений со стороны желудочно-кишечного тракта (ЖКТ). До сих пор открытым остается вопрос о недостатках и преимуществах той или иной группы НПВП.

Цель

Цель. Оценить безопасность и эффективность мелоксикама в дозе 15 мг/сут по сравнению с нимесулидом и плацебо у женщин в постменопаузе с воспалительным фенотипом ОА.

Результаты и обсуждение

Результаты и обсуждение. Частота всех нежелательных явлений была сопоставима среди группы пациентов, принимающих мелоксикам (40,0%), и была ниже, чем в группе нимесулида (48,0%), но выше, чем в группе плацебо. Уменьшение болевого синдрома наблюдалось уже на второй неделе лечения в группе пациентов, принимающих мелоксикам. В группе пациентов, принимающих мелоксикам, и в группе пациентов, принимающих нимесулид, через 3 нед. лечения наблюдалось значимое снижение показателей по шкале WOMAC: общего результата, болевого синдрома, скованности, функции. Мелоксикам и нимесулид продемонстрировали высокую эффективность через 3 нед. по сравнению с исходными параметрами шкалы ВАШ. В группе плацебо эффективность отсутствовала.

Выводы

Выводы. Частота всех нежелательных явлений была ниже при приеме мелоксикама, чем при приеме нимесулида. Наши результаты подтверждают рассмотрение вопроса о назначении мелоксикама в дозе 15 мг один раз в день для лечения боли и скованности при ОА у женщин в постменопаузе.

Introduction

Introduction. Non-steroidal anti-inflammatory drugs (NSAIDs) are currently the mainstay of the management for relieving pain syndrome in osteoarthritis (OA). NSAIDs are characterized by an individual reaction to medication, as well as a quite high frequency of gastrointestinal side effects. The issue of the disadvantages and advantages of a particular group of NSAIDs is still open.

Aim

Aim. To evaluate the safety and efficacy of Meloxicam at a dose of 15 mg/day as compared with Nimesulide and placebo in postmenopausal women with an inflammatory phenotype of OA.

Results and discussion

Results and discussion. The frequency of all adverse events was comparable among the group of patients receiving meloxicam (40.0%), and lower than in the nimesulide group (48.0%), but higher than in the placebo group. A decrease in pain syndrome was observed as early as at 2 weeks of treatment in the group of patients receiving meloxicam. A significant decrease in WOMAC scores (overall result, pain syndrome, stiffness, function) was observed in the group of patients receiving meloxicam, and in the group of patients receiving nimesulide, after 3 weeks of treatment. meloxicam and nimesulide demonstrated high efficacy at 3 weeks compared with the initial VAS scores. The placebo group showed no efficacy.

Conclusion

Conclusion. The frequency of all adverse events was lower while taking meloxicam as compared to nimesulide. Our results substantiate the concept to prescribe meloxicam at a dose 15 mg once daily for the treatment of pain and stiffness in post-menopausal women with OA.

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The authors declare that there are no conflicts of interest present.